In high school, I had to memorize the Preamble to the U.S. Constitution. I did not understand why then, but I do now. This is essentially the mission statement for the United States.

When I served on the U.S. Senate staff during the initial months of the health care reform debate in 2009, I thought that the Preamble should serve as a touchstone for proposed legislation. Given that health care reform legislation would affect every American and about one-sixth of the economy, it seemed prudent to return to first principles to justify such action.

The Preamble begins by saying who wrote it and why. The government derives its power from the people. That power should be used continuously to improve the country that the Founders fought to free from foreign control. Establishing and preserving justice, peace, safety, well-being and liberty were all part of the role of the federal government. Implicit in the singling out of "our posterity" is the idea that this was to be a timeless arrangement that would protect us collectively and individually.

How does the Preamble support health care for every American?

Our government must stand for doing what is best for all citizens collectively and for each individually, balancing these potentially competing interests if possible, but never sacrificing the rights of the individual. That there is such inequity in the provision, access, cost and quality of health care in America is inconsistent with a just country.

Domestic tranquility means peace and safety at home. Getting everyone the care he or she needs, including mental health care, will further the peace and safety of all Americans, not to mention reduce the horrible burden placed on our resources by a costly prison system.

The common defense suggests the outward-looking part of the American mission. To continue to have an all-volunteer military force that can protect us against foreign threats requires the best, brightest and fittest Americans to serve.

The general welfare informs the course of action that is best for America - all America, not just the privileged few. No other part of human existence can trump the physical and mental integrity of the individual for creating a collective general welfare. That requires accessible, affordable medical treatment, accurate diagnosis, disease prevention, appropriate screening and more than anything else, the education for life of every citizen about shopping for food, cooking it, eating well and in moderation, exercising, sleeping and avoiding behaviors that are clearly detrimental to general welfare and individual health like tobacco and drug use.

The debate I witnessed in Washington in 2009 was never based on discussing how to fulfill the mission of the United States through a different form of health care delivery. Rather, a deal was concocted that preserved the basic aspects of the system we already had with third-party support of health care payments, despite the third parties (insurers) adding nothing to the health of anyone, but reaping huge profits for bookkeeping and risk management as a means to maximize shareholder value.

The Founding Fathers left us a guide into the future that they would never see.

Before we took on the debate about what health care reform would be, we probably should have discussed whether its provision to everyone was a right of citizenship. We should have discussed whether it would advance the nation forward. We should have discussed whether the proposals being considered were compatible with the mission.

Instead we debated how to gain access for a few more Americans (but not all) while preserving the profits of even fewer.

I hope Obamacare works, although I don't know what "works" looks like. Whether it does or doesn't, it cannot be the end of meaningful health care reform, for it still leaves out many Americans - particularly in states like Texas without Medicaid expansion. The work is not done. We always get another chance. This time let's compare what is proposed to our mission and build support for any new proposal because it is consistent with our most important principles, not create a system to preserve a flawed system in spite of the principles.

Creating a perfect union starts with creating a healthier one, and that will take more than the Affordable Care Act ever promised to do.